Functional Assessment

Question 1

Barthel Index

Answer 1

Population: older adult population, chronically ill
- assesses the ability of an individual with a neuromuscular or musculoskeletal disorder to do “self care”
Description: 10-item Basic ADL
- can be verbal or performance based
- 5 minutes verbal, 20 minutes performance
Rating:
0 = maximal assistance
15 = good level of independence
100 = patient can do self care

Question 2

Physical Performance Test

Answer 2

Population: older adult in outpatient setting, also been studied with people with Parkinson’s
- assesses a pt’s level of physical function as indicated by tasks which stimulate ADL’s
Mode of Administration: performance and score while patient performs
- takes about 10 minutes, can use all items or only first 7 if you have concerns about stairs
Interpretation: higher score indicates better performance

Question 3

Validity of PPT

Answer 3

score correlates with cognitive status, self-reported health status, and mental health
Predictive values:
- people living at home score > 18.8
- people with score < 18.8 require assistance and were more likely to be in LTC
- people with score < 15.1 were in NH or dead 1 year later

Question 4

Functional Independence Measure(FIM)

Answer 4

Population: adult population; WeeFIM for peds
- measure the level of a patient’s disability and indicates how much assistance is required for the individual to carry out ADL’s
- 18 item tool; determines the degree of disability
Administration: performance; observe the patient performing the tasks; typically parts are scored by multidisciplinary team members
Scoring: score ranges from 18 - 126; motor is 13-91; 7 pt scale
- higher score = more independence

Question 5

validity of FIM

Answer 5

same at Barthel

• score predicts burden of care: lower score = increased assistance
• < 36 = little change; greater burden of care; discharge to nursing home
• 36 - 96 = changed the most; predicting discharge is hard; some may go home, some to NH
• 96 = discharged to home; low level of disability; not much change in score

Question 6

Lawton IADL

Answer 6

Population: geriatric population

• 8 items with a score of 0-8
• interview or self report
• less than 10 minutes
• higher score = more independent
• less reliable
• moderately correlated with BADL and mental status

Question 7

Pain Disability Index

Answer 7

Population: adult with chronic pain

• measures pain related disability; seven visual analog scales; patient is asked to rate the amount of disruption due to pain
• self report
• less than 5 minutes
• higher score = more disability

Question 8

Validity of PDI

Answer 8

patients in inpatient setting have more disability than in outpatient setting

• pt’s with higher scores tend to have more psychological stress, severe pain characteristics, and more restrictions in activities
• higher scores are also seen in patients involved in litigation or who were hurt at work